The traditional perfect attendance award is not supposed to be about sickness, although it does reward good health. It also includes coming to school late and leaving early, for whatever reasons. The point is to get kids to be there as a high priority, instead of ditching school for minor reasons. But when sickness becomes a big issue, maybe kids should not be there.

Each year that a bad flu season hits hard, schools try to discourage parents from sending kids to school if they are feverish or experiencing vomiting or diarrhea. The CDC suggests that kids must stay home until they have been free of such infectious symptoms for 24 hours. Parents, of course, feel pressure to send kids to school so that they can meet their own job obligations. While some have good child care for sick kids, many do not. At worst, some kids go to school regardless of their health, while others stay home while they are sickest but return to school while they are still unwell.

While kids and parents have more important pressures than a school award, the school doesn’t want to be sending mixed messages about health. Round Meadow School in California, interviewed by Today Health, said they are are trying to keep the award but downplay it in a flu season.

For now, the award is in place, but Resnick says he tries to keep it low key – a paper certificate and maybe a gift certificate to a local restaurant – so as not to make it too tempting to come to school sick. Fewer than a dozen of the school’s 550-odd students get the award each year, and out of nine elementary schools in the district, Round Meadow is one of the only schools to still have an annual perfect attendence.

Some advocates say that the best way to split the difference is to reward near-perfect attendance or “improved” attendance.

Hedy Chang, director of Attendance Works, a policy group that works to reduce chronic absence, says schools should reward good or improved attendance rather than take an all-or-nothing approach. That tack can discourage a child who, say, falls ill during the first month of school and then knows she has no chance of winning an award for the rest of the year, she says.

Perfect attendance awards usually reward students who are naturally healthy. Some people simply don’t get infectious diseases, due to strong immune systems and, perhaps, good luck. The CDC is trying to study how students pass germs to each other, to come up with better recommendations. For now, they have mainly common sense to offer:

Kids who want to duck infectious diseases – and maybe maintain an attendance streak – should start by getting all their recommended vaccines, says Dr. Mandy Allison, a pediatrician at the University of Colorado Denver. They should also wash their hands frequently, get enough sleep and eat a healthful diet.

Of course, the real pressure is supposed to be on parents not to pull kids from school for convenience reasons, and on kids not to skip school because they don’t feel like going. Serious attendance problems are rarely about illness. Many high school students just resent going to school and resist their parents’ wishes. Some high schools report major problems with absences.